Laboratory diagnosis of Clostridium difficile associated diarrhoea and molecular characterization of clinical isolates
Articolo
Data di Pubblicazione:
2012
Citazione:
Laboratory diagnosis of Clostridium difficile
associated diarrhoea and molecular
characterization of clinical isolates / G. Russello, A. Russo, F. Sisto, M.M. Scaltrito, C. Farina. - In: NEW MICROBIOLOGICA. - ISSN 1121-7138. - 35:3(2012), pp. 301-310.
Abstract:
We evaluated a three-step algorithm for laboratory diagnosis of Clostridium difficile-associated diarrhoea (CDAD).
First, stool specimens were screened using an EIA test for glutamate dehydrogenase detection. Screen-positive specimens
were tested by a rapid cytotoxintoxin A/B assay and subjected to stool culture. All cultures positive for C. difficile
underwent toxigenic culture.
The results showed that toxigenic culture allowed us to recover 37/156 (24.4%) stool samples harbouring toxigenic C.
difficile that would have been missed by using faecal cytotoxin assay alone. This determined an increase ininfection
prevalence of 4.2% (from 11.4% to 15.6 %).
Furthermore, to characterize the clinical Clostridium difficile isolates and the distribution of PCR ribotypes circulating
in the San Carlo Borromeo hospital, molecular typing using semi-automated repetitive-sequence-based PCR (rep-
PCR) and PCR ribotyping, and an evaluation of the antibiotic resistance were also performed.
Among them, 71 indistinguishable strains were detected by rep-PCR and 83 by PCR-ribotyping revealing C. difficile
outbreaks in our hospital. A total of 6 different ribotypes were obtained by PCR ribotyping. The most frequent ribotype
was 018 (88.2%) that also showed resistance to moxifloxacin. In one case, uncommon PCR ribotype 186 was also
identified.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Clostridium difficile; Nosocomial infection; PCR-ribotyping; Rep-PCR; Toxigenic culture
Elenco autori:
G. Russello, A. Russo, F. Sisto, M.M. Scaltrito, C. Farina
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